Features of walking in patients with knee arthrosis before and after arthroplasty according to the GAITRite system

Background. Hardware examinations are the key to standardizing the assessment of the patient’s condition, they reduce the doctor’s error, make it possible to obtain digital material, which can be used to determine the functional ability of the patient. One of such studies is the GAITRite system, the purpose of which is to assess the parameters of a person’s walking. The study was aimed to determine the basic parameters of walking in patients with gonarthrosis before and after the endoprosthesis. Materials and methods. There were examined 23 patients with gonarthrosis after unilateral endoprosthesis. The studies carried out concern the analysis of temporal, geometric parameters of walking, as well as the assessment of the functional ability of patients with degenerative diseases of the hip joint before treatment and one year after arthroplasty. Results. Before treatment for knee arthrosis, patients experience a violation of walking in the form of asymmetry of steps. There is a decrease in the time of support on the foot of the impaired limb and, therefore, an increase in the time of transfer of the foot of this limb. Changes in the impaired limb are reflected in the opposite one. After surgery, the changes in the parameters of walking in patients were as follows: an increase in the time of support on the prosthetic limb, and, therefore, a decrease in the time of support on the foot of the opposite limb that manifested in an increase in the symmetry of the parameters of steps. Reduction of pain syndrome and restoration of limb support ability increase the indicator of gait functionality. Osteoarthritis is a systemic disease and develops more often in both knee joints, and other structures of the skeleton are often involved in the degenerative process. Therefore, in elderly patients, FAP after arthroplasty reaches only satisfactory values. We examined patients after endoprosthesis on one knee joint, and this does not always give the expected good result immediately. Conclusions. Instrumental methods of studying patients’ gait make it possible to determine the degree of impairment of dynamics. Knee arthroplasty eliminates pain and restores limb resistance, which improves gait. This method of assessing walking allows determining the degree of recovery of patients and to adjust the need for further methods of correcting walking or a plan for further treatment.

NOVEL PHYSIOTHERAPEUTIC APPROACH TOWARDS A CASE OF COMPLEX MULTIPLE FRACTURE

A straddle fracture of the pelvis is a fracture of the superior and inferior pubic rami which is considered an unstable injury. Injuries most often associated with straddle fracture include sacral fracture, neurological injury, pelvic ring disturbance, lumbar spine fracture, and severe soft tissue injury. A pelvic fracture can happen through the mechanism of either moderate or medium intensity effects. This can range in magnitude from relatively minor mishaps to moderately traumatic fractures that are potentially fatal. L5 transverse process fracture are often associated with pelvic ring fractures, which may indicate high energy trauma. A 35-year-old female with a left-sided straddle fracture, a sacral ala fracture associated with an L5 transverse process fracture L5 was diagnosed by orthopaedic surgeon, on X-ray after a slip and fall sustaining injury to pelvic region, on which open reduction and internal fixation with a 5-hole pre-contoured plate was placed. Temporary reduction was done by K-wire and sacral ala fracture was fixed with 2 CC screws. Post operatively the patient had impaired limb movements and inability to perform daily activities. After operation, patient was managed with physical therapy treatment comprising of static regimens, progressing to dynamic exercises, electrotherapeutic techniques, strengthening exercises, gait exercise for duration of 10 weeks. Patient was given physiotherapy regime for 5 days per week for 10 weeks. This study shows that the operative method and timely recovery in physical therapy contributed to the progress of ROM, strength of muscle, functional activities progressively, which successfully led to further recovery.

Pre-Prosthetic Rehabilitation in Post-operative Transtibial Amputation Patient: A Case Report

Background: Amputation is that the removal of injury by, undue constriction, surgical condition or surgery of associate degree extremity. Below-knee amputation (BKA) may be a transtibial amputation that involves separating the foot, ankle joint, and distal shinbone and leg bone from associated soft tissue structures. This surgical treatment carries wide morbidity, but, provided adequate indications; it remains a therapeutic tool with very important clinical price and generally life-saving importance. The majority of transtibial amputations is due to peripheral vascular disease or lower limb circulation disease (60 percent -70 percent).The main goal of rehabilitation procedures is to generally increase healthy and impaired limb strength, patient flexibility, cardiovascular ability, and equilibrium. . Health care is burdened by comprehensive recovery and long-term care. Mobility is essential to independence recovery; however, the effect of multiple comorbidities in this patient population will render mobility recovery a particularly difficult task Clinical Finding: An 65 year old male complains of pain in right foot since 3 month. Swelling was appeared and skin over the black lower leg turned black with foul smelling discharge from foot. He was diagnosed with right lower limb gangrene and referred to Physiotherapy department for prosthetic prescription and rehabilitation after trans tibial amputation. Diagnosis: Duplex colour Doppler study of left lower limb show triphasic flow in CIA, EIA, IIA, SFA, POP, ATA, PTA arteries of right lower limb, dampened flow noted in right dorsalis pedis artery and atherosclerosis wall thickening in the arteries of right lower limb. Conclusion: This case report provides patient with inclusive recovery which help to decide on a patient’s suitability for a prosthetic limb prosthetic fitting.

Misoplegia and dementia: a case study

ABSTRACT. Brain-damaged patients can develop abnormal attitudes towards their deficits. Misoplegia is one such example, involving exaggerated aversion to an impaired limb, sometimes associated with hatred of paresis and verbal or physical abuse directed at the paretic limb. Few studies or reports on this disorder are available in the literature, prompting the present case report of a patient with misoplegia and vascular dementia.

Effect of different thermal stimuli on improving microcirculation in the contralateral foot

Background The lower extremities of the body often suffer from impaired microcirculation, particularly in the elderly or people with underlying conditions such as diabetes. Especially for people suffering from peripheral vascular diseases, skin lesions or wearing an external fixator in one side of limbs, direct contact treatments are not suitable for them to improve microcirculation. Heating the contralateral limb has been reported to improve blood flow in the impaired limb. However, its effect on plantar microvascular responses has not been previously investigated. Thus, the aim of this study was to explore how heating by warm bath and infrared radiation affects the circulations in the contralateral foot. Twelve healthy adults participated in this study and were randomly assigned to either placing the left foot in a warm bath or exposing it to infrared radiation for 10 min intervention every other day. The skin temperature (Temp) and skin blood flow (SBF) in the second metatarsal head of the contralateral foot were measured before and after the intervention. Results The results showed that both Temp (Bath: from 29.05 ± 3.56 °C to 31.03 ± 4.14 °C; Infrared: from 29.98 ± 3.86 °C to 31.07 ± 3.92 °C) and SBF (Bath: from 62.26 ± 48.12 PU to 97.76 ± 63.90 PU; Infrared: from 63.37 ± 39.88 PU to 85.27 ± 47.62 PU) in the contralateral foot were significantly increased after heating in both tests (p < 0.05). However, the contralateral SBF increased for 5 min after heating in warm bath test, but only for 1 min in infrared radiation test. Conclusions The results of this study show that both heating methods are the effective at increasing contralateral Temp and SBF, but the warm bath has a stronger residual thermal effect.

Effect of different thermal stimuli on improving microcirculation in the contralateral foot

Backgroud: The lower extremities of the body often suffer from impaired microcirculation, particularly in the elderly or people with underlying conditions such as diabetes. Especially for people suffering from peripheral vascular diseases, skin lesions or wearing an external fixator in one side of limbs, direct contact treatments are not suitable for them to improve microcirculation. Heating the contralateral limb has been reported to improve blood flow in the impaired limb. However, its effect on plantar microvascular responses has not been previously investigated. Thus, the aim of this study was to explore how heating by warm bath and infrared radiation affects the circulations in the contralateral foot. Twelve healthy adults participated in this study and were randomly assigned to either placing the left foot in a warm bath or exposing it to infrared radiation for 10 minutes intervention every other day. The skin temperature (Temp) and skin blood flow (SBF) in the second metatarsal head of the contralateral foot were measured before and after the intervention.Results: The results showed that both Temp (Bath: from 29.05±3.56 °С to 31.03±4.14 °С; Infrared: from 29.98±3.86 °С to 31.07±3.92 °С) and SBF (Bath: from 62.26±48.12 PU to 97.76±63.90 PU; Infrared: from 63.37±39.88 PU to 85.27±47.62 PU) in the contralateral foot were significantly increased after heating in both tests (P<0.05). However, the contralateral SBF increased for 5 minutes after heating in warm bath test, but only for 1 minute in infrared radiation test.Conclusions: The results of this study show that both heating methods are the effective at increasing contralateral Temp and SBF, but the warm bath has a stronger residual thermal effect.

Intermittent Skill Training Results in Moderate Improvement in Functional Outcome in a Mouse Model of Ischemic Stroke

Background Stroke is a leading cause of disability worldwide. Focused training of the impaired limb has been shown to improve its functional outcome in animal models. However, most human stroke survivors exhibit persistent motor deficits, likely due to differences in rehabilitation intensity between experimental (animal) and clinical (human) settings. Objective The current study investigated the effect of training intensity on behavioral outcome in a mouse model of stroke. Methods Mice were trained preoperatively on a skilled reaching task. After training, mice received a unilateral photothrombotic stroke. Postoperatively, animals received either daily rehabilitative training (traditional intensity), intermittent rehabilitative training (every other day), or no rehabilitative training (control). Assessment of the impaired limb occurred after 14 training sessions (14 days for the Traditional group; 28 days for the Intermittent group). Results Assessment of the impaired limb illustrated that traditional, daily training resulted in significantly better performance than no training, while intermittent training offered moderate performance gains. Mice receiving intermittent training performed significantly better than control mice but did not exhibit reaching performance as strong as that of animals trained daily. Conclusions The intensity of rehabilitation is important for optimal recovery. Although intermediate intensity offers some benefit, it is not intensive enough to mimic the performance gains traditionally observed in animal models. These results suggest that intensive training, which is often unavailable for human stroke survivors, is necessary to achieve an optimal functional outcome. The lower bounds of training intensity for functional benefit still need to be determined.

Effect of different thermal stimuli on improving microcirculation in the contralateral foot

Backgroud: The lower extremities of the body often suffer from impaired microcirculation, particularly in the elderly or people with underlying conditions such as diabetes. Especially for people suffering from peripheral vascular diseases, skin lesions or wearing an external fixator in one side of limbs, direct contact treatments are not suitable for them to improve microcirculation. Heating the contralateral limb has been reported to improve blood flow in the impaired limb. However, its effect on plantar microvascular responses has not been previously investigated. Thus, the aim of this study was to explore how heating by warm bath and infrared radiation affects the circulations in the contralateral foot. Twelve healthy adults participated in this study and were randomly assigned to either placing the left foot in a warm bath or exposing it to infrared radiation for 10 minutes intervention every other day. The skin temperature (Temp) and skin blood flow (SBF) in the second metatarsal head of the contralateral foot were measured before and after the intervention.Results: The results showed that both Temp (Bath: from 29.05±3.56 °С to 31.03±4.14 °С; Infrared: from 29.98±3.86 °С to 31.07±3.92 °С) and SBF (Bath: from 62.26±48.12 PU to 97.76±63.90 PU; Infrared: from 63.37±39.88 PU to 85.27±47.62 PU) in the contralateral foot were significantly increased after heating in both tests (P<0.05). However, the contralateral SBF increased for 5 minutes after heating in warm bath test, but only for 1 minute in infrared radiation test.Conclusions: The results of this study show that both heating methods are the effective at increasing contralateral Temp and SBF, but the warm bath has a stronger residual thermal effect.

Effect of Different Thermal Stimuli on Improving Microcirculation in the Contralateral foot

Backgroud: The lower extremities of the body often suffer from impaired microcirculation, particularly in the elderly or people with underlying conditions such as diabetes. Especially for people suffering from peripheral vascular diseases, skin lesions or wearing an external fixator in one side of limbs, direct contact treatments are not suitable for them to improve microcirculation. Heating the contralateral limb has been reported to improve blood flow in the impaired limb. However, its effect on microvascular responses has not been previously investigated. Thus, the aim of this study was to explore how heating by warm bath and infrared radiation affects the circulations in the contralateral foot. Twelve healthy adults participated in this study and were randomly assigned to either placing the left foot in a warm bath or exposing it to infrared radiation every other day. The temperature (Temp) and skin blood flow (SBF) in the second metatarsal head of the contralateral foot were measured before and after the intervention. Results: The results showed that both Temp (Bath: from 29.05±3.56 °С to 31.03±4.14 °С; Infrared: from 29.98±3.86 °С to 31.07±3.92 °С) and SBF (Bath: from 62.26±48.12 PU to 97.76±63.90 PU; Infrared: from 63.37±39.88 PU to 85.27±47.62 PU) in the contralateral foot were significantly increased after heating in both tests (P<0.05). However, the increase in contralateral SBF lasted 5 minutes after heating in a warm bath, but only lasted for 1 minute after infrared exposure. Moreover, the increase in Temp from the baseline in the first minute of the Recovery stage was significantly greater when using the warm bath than infrared radiation. Conclusions: The results of this study show that both heating methods are the effective at increasing contralateral Temp and SBF, but the warm bath has a stronger residual thermal effect.

Sudeck syndrome — current understanding of pathogenesis, risk factors, diagnosis and treatment (literature review)

One of the serious complications after limb injuries is the development of Sudeck–Turner syndrome (refl ex sympathetic dystrophy). The pathology development frequency has recently increased, and varies, according to various literary sources, from 5 to 40 %. The pathology has a progressing nature, and is accompanied by chronic pain, impaired limb function, trophic disorders, gradual deformation of the limb, the development of osteoporosis, stiffness of adjacent joints, and often ends with the patient disability. Patients of this category have a long time treatment (up to 4–6 or more months after removal of immobilization). Various methods of conservative treatment are used: drug therapy, physiotherapy, exercise therapy, blockade, and finally with prolonged and unsuccessful conservative therapy, various types of surgical techniques. But even for the entire complex of modern treatment methods applying the outcome could be unfavorable - contracture develops. So the severity and duration of the disease, the treatment low efficiency, the unpredictability of the pathological process outcome forces traumatologists to look for new treatment methods.